Exton Medicaid providers submitted $8,314,572 in claims for services under the National Codes Established for State Medicaid Agencies category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That total represents a 1128.2% rise from 2023, when $676,963 was billed for the same service group.
Medicaid is a state-administered public health insurance program that is funded jointly by state and federal governments. The program serves low-income individuals and families, children, seniors, and those with disabilities, making it one of the largest sources of health coverage in the United States.
As Medicaid payments are sourced from taxpayer funds, shifts in local billing levels reflect how public health care dollars are spent within a community.
The “National Codes Established for State Medicaid Agencies” category represents a set of services billed to Medicaid and defined according to care type, using standardized HCPCS and CPT code groupings. For this analysis, service codes were classified under a single service category by matching code prefixes and numeric ranges, in order to avoid double counting and to maintain accurate rankings over time.
National Codes Established for State Medicaid Agencies ranked first among all Medicaid service categories in Exton by total payments in 2024, as overall Medicaid spending rose across multiple categories.
At the state level in Pennsylvania, this category secured the second spot for total Medicaid payments during 2024.
In the five years leading up to 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Exton increased by $8,314,572, or 0%. Some intervals saw accelerated growth, including significant year-over-year increases noted in 2022 and 2023.
While Medicaid payments for this category were distributed throughout Exton, the majority of funds were concentrated in a small number of ZIP codes. In 2024, ZIP code 19341 alone accounted for $8,314,572, representing 100% of Exton’s Medicaid payments for the category that year.
Payments within the National Codes Established for State Medicaid Agencies category were also focused among a narrow group of billing codes.
To compare, Medicaid claims tied to National Codes Established for State Medicaid Agencies increased 1128.2% in Exton from 2023 to 2024, compared with an overall 20.6% change across all Medicaid claim categories in the city for the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached around $871.7 billion in fiscal year 2023. This figure comprised about 18% of all national health expenditures, up markedly from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This growth equates to an increase of about 40% over a few years, largely due to expanded enrollment and higher service utilization throughout and after the pandemic period.
Recent federal budget measures under the Trump administration have included major proposals aimed at reducing federal Medicaid funding and changing the program’s structure. For example, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut federal Medicaid spending by over $1 trillion in the next decade. The law includes provisions such as work requirements and increased cost-sharing, measures forecast to reduce both coverage and funding for some recipients. As a result, additional costs may shift to states and the pace of federal support will slow, even though Medicaid continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2022 | $666,862 | – |
| 2023 | $676,962 | 1.5% |
| 2024 | $8,314,572 | 1128.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $8,314,572 | 42.7% |
| 2 | Temporary National Codes (Non-Medicare) | $6,454,475 | 33.2% |
| 3 | Medicine Services and Procedures | $3,232,801 | 16.6% |
| 4 | Procedures / Professional Services | $1,021,987 | 5.3% |
| 5 | Evaluation and Management | $194,267 | 1% |
| 6 | Ambulance and Other Transport Services and Supplies | $120,291 | 0.6% |
| 7 | Vision Services | $66,360 | 0.3% |
| 8 | Dental Services | $36,265 | 0.2% |
| 9 | Alcohol and Drug Abuse Treatment | $10,178 | 0.1% |
| 10 | Durable Medical Equipment | $1,245 | <0.1% |
| 11 | Pathology and Laboratory Procedures | $948 | <0.1% |
| 12 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 12 | Medical And Surgical Supplies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1003 | Lpn/lvn services up to 15min | $5,622,862 | 27 |
| T2025 | Waiver service, nos | $2,576,466 | 11 |
| T1002 | Rn services up to 15 minutes | $115,243 | 3 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.
